What is ankle osteoarthritis?

The ankle joint is often damaged due to the large load it is subjected to. A diagnosis such as ankle osteoarthritis is not uncommon. It is decided regardless of the age and gender of the patient. What is ankle osteoarthritis and how can it be treated?

What is it?

There is an extraordinary load on the ankle. Its function is to keep the body straight. Thanks to him, a person walks and runs. With a violation of the ankle system, it is extremely difficult to lead a familiar lifestyle. What disrupts ankle function?

Ankle osteoarthritis, what is it? It is a chronic joint disease, which is characterized by a degenerative course. In the cartilage of the joint, irreversible processes are induced, which lead to frightening complications.

Osteoarthritis of the ankle develops gradually. Healthy joint surfaces are elastic and smooth. They provide cushioning under heavy loads and smooth sliding while driving. With pathology, tissue trophism and metabolism are disturbed. The surface of the joint becomes inelastic and rough. During movement, the jumps come in contact with each other, which leads to inflammation. When you lift weights, the main load falls on the bone, which threatens degenerative disorders.

Lack of treatment leads to more serious disorders. In 3-4 stages, cartilage and tissue damage is observed. The synovium becomes inflamed. The connection becomes unstable. The support function is violated. All these violations as a whole lead to the fact that movement becomes impossible.

Osteoarthritis is one of the most common joint diseases that affects quite a large number of people.

Causes and risk factors

What is ankle osteoarthritis, we have solved. Now let us find out what its root cause is. Ankle osteoarthritis is considered to be a pathology of old age. This is due to age-related changes in the body. The cartilage becomes thinner, the bones become unstable and fragile. However, over the last decade, the diagnosis of ankle osteoarthritis has become much newer. Such statistics are disappointing, as many patients ignore the first signs of the disease. Late diagnosis always threatens the development of serious complications.

Provocative factors include:

• dislocations;
• bruising;
• inflammatory diseases;
• damage;
• excess weight;
• impaired metabolism;
• unbearable physical activity;
• wearing uncomfortable shoes;
• autoimmune and endocrine diseases;
• osteochondrosis.

Clinical symptoms

Osteoarthritis of the ankle is recognized by the following characteristics:

1. Pain. It is mild at first and appears after walking or physical exertion. Sometimes when a person is in an uncomfortable position. As the pathological process progresses, the pain syndrome intensifies and is already disturbed at rest.
2. Swelling and inflammation. These signs appear against the background of injuries and dislocations. The body temperature in the affected area rises.
3. ClickWhen the ankle is affected, the click is "dry" and triggers a pain attack.
4. Displacement or subluxation. Due to the thinning and degradation of cartilage tissue, the joint becomes unstable. The bones may shift and fall out of the joint capsule. These changes cause periods of acute pain.
5. Joint stiffness. When cartilage tissue is replaced, the bone node ceases to function normally, which negatively affects its mobility.
6. Joint deformation. Symptoms appear in 3-4 stages of osteoarthritis. Osteophytes also lead to ankle flexion.

If any of the symptoms appear, it is recommended that you see a doctor immediately. Timely treatment is a step towards healing.

Osteoarthritis of the ankle and ankle is characterized by slow progression with a gradual development of clinical manifestations over several years.

Classification and stages

The disease develops in different ways. In some patients, some years pass from the first signs to the final stage, in others, the rapid development of the disease is observed. The speed depends on the age and state of health of the patient, the time of starting therapy. The symptoms of ankle osteoarthritis become brighter as the disease progresses.

There are four stages of osteoarthritis:

1. The first stage is often unnoticed. Sometimes morning stiffness and ankle pain appear after a heavy strain. When the foot moves, a characteristic crack is heard. Pathological changes are not yet visible on X-rays, but the destructive process of cartilage has already begun.
2. The stiffness of the morning is prolonged. It takes 20-30 minutes to develop a leg. Sometimes lameness occurs. Grade 2 arthrosis of the ankle is recognized on roentgenogram by bone tissue growth, bone displacement.
3. Symptoms in 3 stages are pronounced. Pain is no longer a concern only after a heavy load, but also at rest. It is difficult for a patient to do without painkillers. Stupidity increases. Crutches may be needed. The affected joint is swollen and deformed. Ankle muscle atrophy. X-ray shows a narrowing of the joint space, the formation of osteophytes, subluxation.
4. Stage 4 is the hardest. It develops as a result of lack of treatment. The cartilage is destroyed, the surfaces of the joints are melted. Walking is no longer possible.

With the development of osteoarthritis of the ankle, there is a gradual change in the cartilage and bone tissues of the articular surfaces.

diagnostic

The diagnosis of ankle osteoarthritis is based on clinical symptoms and information obtained during examinations. Laboratory studies are considered ineffective, as there are no special tests that can detect pathology. During the remission period, all indicators are within normal limits, with an exacerbation of the disease, a clinical blood test will show a high level of C-reactive protein and ESR. These indicators indicate that the pathological process has already begun.

Instrumental methods are used to confirm the diagnosis:

• radiography;
• Magnetic resonance imaging;
• Ultrasound;
• bone scintigraphy;
• diagnostic puncture of the joints.

Plain radiography

Plain radiography is the most reliable and effective method for diagnosing diseases that occur in the musculoskeletal system. The principle of manipulation is the different absorption of X-rays by muscle tissue. Soft tissues allow X-rays to pass through, but hard tissues absorb. An X-ray allows you to diagnose both the disease itself and its consequences.

Conventional radiography is an examination method in which a small amount of X-rays are transmitted through a person's body or part of the body.

The viewfinder allows you to see:

1. Condition of bone surfaces in articulation.
2. The shape, size and arrangement of the structures in the joints are relative to each other.
3. Condition of the fabric.
4. The size of the common space.

These indicators help the doctor determine the type and extent of joint damage. If the data are not enough, then doctors prescribe other studies.

With ankle osteoarthritis, an X-ray is done in three projections:

• side;
• back;
• back with one foot moved inward.

The disease is characterized by the following changes:

• reduction of common space;
• the presence of osteophytes;
• bone cartilage replacement (subchondral sclerosis);
• small gaps in the periarticular part.

Nuclear magnetic resonance

Nuclear magnetic resonance imaging (NMR) as a diagnostic method allows you to study those parts of the body where there is water. The image shows the bones in dark color because they contain less water but the muscle tissue, discs and nerves appear lighter. MRI allows you to detect the smallest changes in the structure of bone and joint tissue. The study is also prescribed to patients before joint prosthetics. YMG has one disadvantage - a high price.

In nuclear magnetic resonance, a change in the properties of hydrogen molecules is recorded under the influence of a strong magnetic field.

Magnetic resonance imaging

Magnetic resonance imaging (MRI) is an alternative diagnostic method that allows you to carefully examine the ligament structure of joints, muscles and cartilage tissue. With the help of an MRI, the doctor assesses the condition of the lower leg joints. Based on the survey data, the pathology is detected at an early stage of development.

The diagnostic principle is based on exposure to radio waves and strong magnetic radiation. The magnetic field used is not dangerous and does not pose a health risk.

MRI is contraindicated in case of mental disorders, during pregnancy and in the presence of metal objects in the human body.

When diagnosing ankle osteoarthritis, classic (closed-type) MRI machines are used, as they have better image quality. An MRI machine is a large, cylindrical tube with a magnet around it. The patient lies on a separate table. The ankle is fixed with a special spiral. The procedure takes 30-40 minutes. The study is absolutely painless. Patients may feel warmth in the lower leg.

ULTRASOUND

Ultrasound examination has been widely used in medicine since the 1990s. This technique is well proven in making accurate diagnoses. An ultrasound scan is also performed for ankle osteoarthritis.

Today, ultrasound examination has no special significance in the diagnosis of osteoarthritis, as it does not allow a fairly good study of the damaged joints.

The device with which the study is performed produces waves at ultra-frequencies. The waves are reflected from the tissues and recorded on the monitor. Based on the resulting image, the doctor determines the type of pathology. To make the image on the monitor clear, a special gel is used. It eliminates air gaps and gives the sensor better sliding.

Ultrasound examination does not harm the patient, so the procedure can be repeated many times. The advantages of ultrasound also include low cost and high accuracy.

The following indicators are a clear sign of osteoarthritis:

• cartilage thinning;
• the presence of bone growths;
• accumulation of leakage in the joint cavity (synovitis);
• loss of cartilage space.

Bone syntography

Scintigraphy is a high-precision study that, using isotopes, is able to detect pathological changes in bone. Doctors divide pathogenic foci into "cold" and "hot". In the first case, we are talking about areas in which there are no isotopes. These areas are poorly supplied with blood and are not visible during the scan. "Cold" areas are places that are affected by malignant tumors. In "hot" areas, isotopes accumulate quickly and they look very bright when scanned. Such areas indicate the presence of inflammatory processes.

The role of scintigraphy in osteoarthritis is important. The study helps to distinguish osteoarthritis from a number of other diseases when the clinical symptoms are extremely similar.

During bone scintigraphy, a special preparation containing specially labeled atoms is injected into the body.

Based on the scintigraphy results, the doctor makes a clinical prognosis and determines the treatment regimen. The only drawback of the study is its high cost. Scintigraphy is performed using special equipment, and, unfortunately, not all medical institutions can afford its purchase.

Although radioactive scanning is a safe procedure, it still has a number of contraindications:

• pregnancy;
• lactation period;
• taking barium-containing medicines.

When a radioactive substance is injected, some patients experience an allergic reaction in the form of itching and redness. These side effects do not cause risks and disappear on their own in a short time.

Joint puncture

Joint puncture is a diagnostic procedure in which a needle is inserted into the articular cavity in order to collect synovial fluid. This fluid is then sent for further research. Based on the data obtained, the doctor makes a conclusion about the nature of the disease and the stage of its development.

At first glance, a puncture is a simple procedure, but it is not. Withdrawal of fluid from the articular capsule requires exceptional precision of the physician's movements. The synovium is very thin and a hard movement traumatizes it. As a result, an inflammatory process develops. Potential risks also include infection. It is not difficult to get the infection into the wrist capsule through poorly sterilized instruments.

The manipulation technique is different for each node. When collecting the articular exudate from the ankle, the puncture is made forward, between the external ankle and the tendon of the extensor digitorum longus.

Taking diagnostic samples of intra-articular fluid allows laboratory analysis and excludes inflammatory arthritis.

Basic principles of treatment

After confirmation of the diagnosis of ankle osteoarthritis, the symptoms will not be long in coming. Treatment begins immediately. Further prognosis depends on a well-chosen treatment regimen and timing of onset.

Osteoarthritis is an underlying disease. It cannot be completely cured. The goal of therapy is to stop the degenerative processes and extend the remission period. For this purpose, doctors prescribe medicines, physiotherapy, massage, healing gymnastics and folk remedies. If all the conditions are met, it is possible to rely on positive dynamics, otherwise the disease progresses.

Medication therapy for osteoarthritis

Depending on the therapeutic effect, the drugs are divided into several groups:

1. Anti-inflammatory or pain reliever. This group of medications aims to eliminate the focus of inflammation and relieve pain. The earlier anti-inflammatory therapy is started, the greater the chances of saving the joint. Medicines in this group can be produced in the form of tablets and oils.
2. Glucocorticoids. These drugs are prescribed when the above funds are ineffective. They are produced in the form of a solution for injection. The drug is injected directly into the joints.
3. Chondroprotectors. Designed to slow cartilage destruction.

The treatment regimen and dosage are chosen by the physician, based on the severity of the symptoms, the age of the patient, the presence of concomitant diseases, and other factors. Self-medication is dangerous and often worsens the situation, as many of the medications have a number of side effects and have their own contraindications.

Characteristics of radical treatment

If conservative therapy has failed, then doctors are forced to use a radical method of treatment (surgical intervention). The operation is also indicated when:

• secondary (post-traumatic) and primary arthrosis of 3-4 degrees;
• osteoarthritis with complications;
• persistent and severe pain in the ankle, radiating to the knee;
• severe lameness;
• paresis and paralysis of the leg muscles;
• violation of the flexural-extensor function of the joint;
• violation of the supporting ability of the foot.

Surgical intervention is contraindicated if:

• the patient is under 12 years old;
• fistulas are found in the joints;
• the patient has a history of diabetes mellitus, heart failure;
• Infectious diseases were found in the area of the proposed intervention.

Traditional treatment

Doctors believe that the treatment of osteoarthritis should be carried out exclusively under the supervision of a specialist, but they do not deny the positive effect of folk remedies. Alternative treatment acts as an effective prophylaxis that helps eliminate symptoms and maintain remission.

Folk remedies are a rather symptomatic treatment for osteoarthritis of the foot.

Home treatment should be coordinated with your doctor to avoid side effects and complications.

Traditional healers suggest treating ankle osteoarthritis with:

1. Rodhe. Wash burdock leaves with soap and running water. Apply the leaves with the soft side on your skin. Secure the top with a bandage or adhesive tape. Better yet better to keep the compress on all night.
2. Sea salt. Cut the salt into a pan. Throw it in a linen bag and stick it on the ankle. Hold the bag until the salt has cooled. The heat relieves the pain. Sand, lentils, buckwheat are also used instead of salt.
3. Lilac Pour the triple cologne over the lilac flowers. Let the tincture stand in a dark, cool place for 10-14 days. Massage the affected area in the morning and evening.
4. Egg shell. Grind the shells in a coffee grinder. Take the resulting powder per. Tablespoon. before eating.

Remember that treatment with folk remedies should not be the only measure. Complex treatment includes medication, exercise therapy, massage, physiotherapy, spa treatment. In advanced cases, doctors use radical measures - surgical intervention.

Surgery

For osteoarthritis of the foot, the following types of surgeries are used in medicine:

• arthrodesis of the joint;
• arthroscopy of the joint;
• endoprosthetics.

Arthrodesis is an operation to immobilize a joint. It is performed to turn the limb of the lost supporting ability. The only drawback of the operation is that the bones (tibia and talus) grow together, which leads to immobility. Arthrodesis is rarely used in medical practice.

Arthroscopy is a minimally invasive procedure. During the operation, the doctor makes small incisions in the wrist area and through them inserts an arthroscope (a special tube at the end of which a camera is installed). With its help, the surgeon carefully examines and assesses the condition of the intra-articular structures. If necessary, pieces of the damaged node or blood clots are removed from the synovial fluid. This manipulation is less traumatic. The only drawback of arthroscopy is that the risk of recurrence is very high.

Endoprosthetics is the ultimate treatment. It is performed with advanced osteoarthritis. Endoprosthetics allow you to replace the affected joint partially or completely. As a prosthetic product, innovative prostheses with modernized mechanics are used. An artificial knot lasts from 10 to 20 years.

Power characteristics

To achieve a favorable result, drug treatment is supplemented with diet therapy. Nutritionists have developed a special diet to avoid the aggravation of the disease and at the same time provide the body with all the necessary vitamins and nutrients. Diet for overweight patients plays a special role. Since overweight is one of the reasons for the development of osteoarthritis, weight correction is an integral part of treatment.

The patient should reconsider a number of his habits in daily life, which contribute to and provoke the progression of osteoarthritis of the foot.

Nutritionists recommend adhering to the following nutritional conditions:

1. Eat often and in small portions.
2. Drink at least 2 liters of juice a day.
3. Give up sweets and salt.
4. The last meal is no later than 18. 00.
5. Dishes are allowed to steam, boil or bake.

The main task of the diet for osteoarthritis is a balanced and fortified diet. Fasting is not a question. Heavy diets and body cleansing do more harm than good. Calcium is excreted out of the body, which is needed for cartilage restoration. A nutritionist will help you design a daily diet.

With osteoarthritis, it is allowed to eat cereals, pasta, dairy products, cheese, legumes, vegetables, fruits, rye bread, dried fruits, nuts, fish, poultry. Heavy and fatty dishes, foods that contain color and flavor, as well as pickles, marinades, smoked meats, fatty soups, baked goods, spices, sauces, chocolate, ice cream, coffee and alcohol are prohibited.

Prevention of osteoarthritis

To avoid the development of osteoarthritis of the ankle, doctors recommend taking preventive measures:

• wear comfortable shoes without heels;
• follow a diet and drink enough fluids;
• take seasonally complex vitamins and minerals;
• not;
• walk more in the fresh air;
• eliminate excessive stress on the legs;
• avoid hypothermia;
• to be examined by a doctor in a timely manner.

With existing osteoarthritis, it is recommended to correct lifestyle:

1. Rejection of bad habits. They have been shown to provoke blood clots in tissues and accelerate cartilage destruction.
2. Perform a series of exercises to warm up the ankle.

prediction

Osteoarthritis is a progressive disease. Without treatment, it leads to irreversible consequences and complete immobility of the joint. Early diagnosis of pathology allows you to do without radical measures. Medications are able to suspend the pathological process and alleviate the patient's condition. The fight against the disease in the early stages is without complications.